Relationship Between Treatment Comorbidities and HIV Viral Suppression Among People Who Live With AIDS in Johannesburg.

Abstract

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset (<em>n</em> = 602) was used for the descriptive and logistic regression analysis. Results revealed a statistically significant association between tuberculosis treatment and viral suppression—adjusted <em>OR</em> = 1.534, (1.053, 2.234), and <em>p</em> = 0.02—indicating that treatment of comorbidities, such as tuberculosis, has positive impact on viral suppression outcomes. Results, however, revealed that the model for diabetes treatment and viral suppression—<em>OR</em> = 0.993, (0.658, 1.498), and <em>p</em> = 0.97—and the model for cancer treatment and viral suppression—<em>OR</em>= 1.234, (0.844, 1.805), and <em>p</em> = 0.27—were not statistically significant. Treatment of comorbidities, such as TB and HIV, positively impacts viral suppression outcomes. These findings suggested that concurrent, simultaneous, or integrated treatment models for comorbidities can help to achieve HIV viral suppression. This study contributes to positive social change by highlighting the effect of treatment comorbidities on viral suppression in people living with HIV (PLWHIV) in an under-resourced setting, which could inform policy and influence decisions on HIV care and management.